Buy Neuromidin solution intravenously and intramuscularly 5mg/ml 1ml No. 10 in pharmacies

Neuromidin is an anticholinesterase agent that has a direct effect on the functions of the central nervous system. It is used to treat various diseases of the nervous system, including those caused by injuries. Pharmacological action develops quickly. The drug is prescribed for adults and children over 14 years of age.

Nosological classification (ICD-10)

• F09 Organic or symptomatic mental disorder, unspecified
• G12.2 Motor neuron disease
• G37.9 Demyelinating disease of the central nervous system, unspecified
• G58 Other mononeuropathies
• G61 Inflammatory polyneuropathy
• G62 Other polyneuropathies
• G62.9 Polyneuropathy, unspecified
• G70 Myasthenia gravis and other neuromuscular junction disorders
• G92 Toxic encephalopathy
• G96.8 Other specified disorders of the central nervous system
• G96.9 Damage to the central nervous system, unspecified
• K59.8.0* Intestinal atony
• M79.2 Neuralgia and neuritis, unspecified

Interactions with other medications

Neuromidin may also interact with other medications. It enhances its sedative effect if used with drugs that depress the central nervous system, such as sleeping pills, tranquilizers from the benzodiazepine group, or together with barbiturates. Let us recall that a well-known representative of barbiturates, phenobarbital, is included in Valocordin and Corvalol, which are sold without a prescription. If you combine Neuromidin with beta-blockers, which reduce the heart rate and heart function, there is a risk of bradycardia, collapse and fainting.

Compound

Mechanism of action of the drug

It is known that the nerves give the order to the muscles to contract, acetylcholine, which is released into the synaptic cleft - the place where the nerve connects with the muscle. Acetylcholine, if not removed in time, will keep the muscle in prolonged contraction. Therefore, “cleaning” the synaptic cleft from acetylcholine is very important, and this is done by the enzyme acetylcholinesterase. So, Neuromidin inhibits it, and acetylcholine circulates longer in the synaptic cleft, and the impulse becomes brighter, longer, more active. It affects the level of potassium channels. As a result, neuromuscular transmission and smooth muscle contractility improve.

Pharmacodynamics

Neuromidin® has a direct stimulating effect on the conduction of impulses along nerve fibers, interneuronal and neuromuscular synapses of the central nervous system and the peripheral nervous system. The pharmacological action of Neuromidin® is based on a combination of two mechanisms of action: blockade of potassium channels in the membrane of neurons and muscle cells; reversible inhibition of cholinesterase at synapses.

Neuromidin® enhances the effect on smooth muscles of not only acetylcholine, but also adrenaline, serotonin, histamine and oxytocin.

Neuromidin® has the following pharmacological effects:

– improves and stimulates impulse conduction in the nervous system and neuromuscular transmission;

- enhances the contractility of smooth muscle organs under the influence of agonists of acetylcholine, adrenaline, serotonin, histamine and oxytocin receptors, with the exception of potassium chloride;

- improves memory, inhibits the progressive course of dementia.

In preclinical studies, Neuromidin® did not have teratogenic, embryotoxic, mutagenic, carcinogenic or immunotoxic effects, and did not affect the endocrine system.

Pharmacological properties of the drug Neuromidin

The action of ipidacrine (9 amino-2,3,5,6,7,8-hexahydro-1 H-cyclopentane (b) quinoline hydrochloride monohydrate) is due to a biologically beneficial combination of two molecular effects - blockade of potassium membrane permeability and reversible inhibition of cholinesterase activity. In this case, blockade of potassium permeability of the membrane plays a leading role. Blockade of potassium permeability of the membrane leads primarily to an increase in the repolarization phase of the action potential of the excited membrane and an increase in the activity of the presynaptic axon. This leads to an increase in the entry of calcium ions into the presynaptic terminal, which in turn leads to an increase in the release of transmitter into the synaptic cleft at all synapses. An increase in the concentration of the transmitter in the synaptic cleft promotes stronger stimulation of the postsynaptic cell due to the mediator-receptor interaction. In cholinergic synapses, inhibition of cholinesterase causes even greater accumulation of the neurotransmitter in the synaptic cleft and increased functional activity of the postsynaptic cell (contraction, conduction of excitation). Neuromidin enhances the effect of acetylcholine, adrenaline, serotonin, histamine and oxytocin on smooth muscles. The drug has the following pharmacological effects: stimulation and restoration of neuromuscular transmission; restoration of impulse conduction in the peripheral nervous system after its blockade by various agents (trauma, inflammation, exposure to local anesthetics, some antibiotics, potassium chloride and other factors); increased contractility of smooth muscle organs; specific moderate stimulation of the central nervous system with individual manifestations of sedation; improvement of memory and learning; analgesic and antiarrhythmic effect. The drug does not have teratogenic, embryotoxic, mutagenic and carcinogenic, as well as allergenic and immunotoxic effects, and does not affect the endocrine system. Rapidly absorbed after oral administration. The maximum concentration in blood plasma is observed 1 hour after oral administration and 25–30 minutes after subcutaneous or intramuscular administration. From the blood, the drug quickly enters the tissues and at the steady state stage, only 2% of the drug is detected in the blood serum. The half-life in the distribution phase is 40 minutes. The degree of binding to blood proteins is about 40–50%. Absorbed predominantly in the duodenum, to a lesser extent in the jejunum and ileum, only 3% of the dose is absorbed in the stomach. Elimination from the body is carried out through a combination of renal and extrarenal mechanisms (biotransformation, excretion in bile), with excretion in urine predominating. Only 3.7% of the drug is excreted unchanged in the urine, which indicates its rapid metabolism in the body.

Pharmacokinetics

After oral administration, intramuscular and subcutaneous administration, it is rapidly absorbed. Cmax in blood plasma is achieved 1 hour after oral administration and 25–30 minutes after intramuscular or subcutaneous administration. Binding to blood plasma proteins is 40–50% of the active substance. It quickly enters the tissues, the half-life of distribution is 40 minutes. Metabolized in the liver. It is excreted through the kidneys (mainly by tubular secretion and only 1/3 by glomerular filtration) and extrarenally (through the gastrointestinal tract). T1/2 of Neuromidin® when administered parenterally is 2–3 hours. After parenteral administration, 34.8% of the drug dose is excreted unchanged in the urine.

Contraindications

hypersensitivity to any of the components of the drug;

epilepsy;

extrapyramidal diseases with hyperkinesis;

angina pectoris;

severe bradycardia;

bronchial asthma;

mechanical obstruction of the intestine or urinary tract;

vestibular disorders;

peptic ulcer of the stomach or duodenum in the acute stage;

pregnancy (the drug increases the tone of the uterus);

lactation period;

children under 18 years of age (no systematic data on use).

With caution: for gastric and duodenal ulcers, thyrotoxicosis, cardiovascular diseases, as well as for patients with a history of obstructive diseases of the respiratory system or acute respiratory diseases.

Additionally for tablets

With caution: with lactase deficiency, lactose intolerance, lactose/isomaltose malabsorption syndrome, because the drug contains lactose.

Buy Neuromidin solution intravenously and intramuscularly 5mg/ml 1ml No. 10 in pharmacies

Instructions for use

Neuromidin solution IV and IM 5 mg/ml 1 ml No. 10

Dosage forms injection solution 5 mg/ml 1 ml Synonyms Axamon Ipigrix Group Cholinesterase inhibitors International nonproprietary name Ipidacrine Composition Active substance: Ipidacrine. Manufacturers: Olainfarm JSC (Latvia), Olainfarm JSC, packaged Sopharma JSC (Latvia), Olainfarm Olainsky HFZ (Latvia) Pharmacological action Reversibly inhibits cholinesterase, stimulates impulse conduction in neuromuscular synapses and in the central nervous system due to blockade of potassium channels of the excitable membrane. Restores and stimulates neuromuscular transmission (including in the peripheral nervous system), enhances the contractility of smooth muscle organs, moderately stimulates the central nervous system, improves memory and learning. Does not have teratogenic, embryotoxic, mutagenic, carcinogenic, allergenic, or immunotoxic effects. Does not affect the endocrine system. The drug penetrates well into all tissues of the body, increases the tone of the uterus and can cause premature birth. The drug can be used for weak labor. After oral administration, it is quickly absorbed. It is excreted through the kidneys and through the gastrointestinal tract, mainly in the form of metabolites. Side effects: Dizziness, bradycardia (can be eliminated with m-anticholinergic blockers), hypersalivation (can be eliminated with m-anticholinergic blockers), nausea, vomiting, itching, rash. Indications for use Diseases of the peripheral nervous system in adults (neuritis, polyneuritis, polyneuropathy, polyradiculoneuropathy, myasthenia gravis); bulbar palsy and paresis, organic lesions of the central nervous system, accompanied by nervous disorders (recovery period); demyelinating diseases (complex therapy), intestinal atony. Contraindications Hypersensitivity, epilepsy, extrapyramidal disorders, severe bradycardia, angina pectoris, bronchial asthma, vestibular disorders, gastric ulcer in the acute stage, pregnancy, breastfeeding. Overdose Treatment: prescription of m-anticholinergics, incl. atropine, cyclodol, etc. Interaction Strengthens the sedative effect of central nervous system depressants. M-cholinomimetics and other cholinesterase inhibitors increase the effect and side effects (the risk of a cholinergic crisis increases, especially in patients with myasthenia gravis). Beta-blockers cause bradycardia if they were used before treatment with Neuromidin. When used simultaneously with alcohol, adverse side effects may increase. Special instructions The drug increases the muscle tone of the uterus and can cause premature labor. Caution should be used for stomach ulcers, thyrotoxicosis, and diseases of the cardiovascular system. The drug penetrates well into tissues and organs, incl. brain and may have a sedative effect. Care should be taken when working with machinery. During treatment you should not drink alcohol. Storage conditions List A. In a place protected from light, at a temperature not exceeding 25 °C.

Side effects

Caused by stimulation of m-cholinergic receptors: salivation, increased sweating, palpitations, nausea, diarrhea, jaundice, bradycardia, epigastric pain, increased secretion of bronchial secretions, bronchospasm, convulsions. Salivation and bradycardia can be reduced with m-anticholinergic drugs (atropine, etc.). Increased uterine tone, allergic skin reactions.

Rarely (after using higher doses), dizziness, headache, chest pain, vomiting, general weakness, drowsiness, and skin reactions (itching, rash) were observed. In these cases, reduce the dose or interrupt the drug for a short time (for 1–2 days). These side effects are observed in less than 10% of patients.

Modern spinal neurosurgery

Only modern minimally invasive surgical intervention (for example, video endoscopic microdiscectomy, or laser vaporization and nucleoplasty) can remove the hernia defect itself, or prevent its appearance in the case of protrusion. However, the Russian patient knows very well what surgery is. It hurts. This takes you out of normal life for a long time. It may be dangerous. There are so many such “buts” that surgery is considered the last type of treatment, when massage therapists, carboxytherapy sessions, manual therapists and kinesiotherapists stop helping.

Fortunately, in European countries, Israel, and the USA, the approach is completely different. If there are indications, the patient is operated on without pain, and often leaves the hospital on his own feet on the same day or the next. His quality of life is preserved. He is not prohibited from sitting for many days, and he is not forced to relieve himself while standing. Therefore, modern surgery is considered the best, fastest and most effective means of radical treatment. By the way, doctors in many Eastern European countries, for example, the Czech Republic, show excellent results in treating hernias surgically at fairly modest costs.

In Russia, they prefer not to immediately remove the hernial protrusion, but for many years to deal with its consequences and complications - to periodically treat inflammation, pain and swelling of the roots, which persistently arise again and again. And in this respect, the domestic patient resembles an unfortunate driver who, instead of finally changing a punctured tire, is forced to pump it up every half hour of driving. Only, unlike the driver, a patient who has been “treating” a hernia for a long time sometimes spends several times more money than the operation would cost.

Cervical hernia on MRI.

But even among the drugs for relieving swelling, back pain, and excess muscle tension, Neuromidin is not “listed.” However, it is sometimes prescribed for hernias, and is completely unjustified. The situation is aggravated by an unimaginably large number of sites that are written with stunning medical illiteracy. Because if there is a request “How to take Neuromidin for hernias,” then a helpful but illiterate article will immediately appear, which can even harm your health. How to take Neuromidin for hernias? Don't accept it at all. But first things first….

Interaction

Neuromidin® enhances the sedative effect in combination with CNS depressants.

The action and side effects are enhanced when used together with other cholinesterase inhibitors and m-cholinomimetic drugs. In patients with myasthenia gravis, the risk of developing a cholinergic crisis increases if Neuromidin® is used simultaneously with other cholinergic drugs.

The risk of developing bradycardia increases if β-blockers were used before starting treatment with Neuromidin®.

Neuromidin® can be used in combination with nootropic drugs.

Alcohol increases the side effects of the drug.

Reduces the inhibitory effect on neuromuscular transmission and the conduction of excitation along peripheral nerves by local anesthetics, aminoglycosides, and potassium chloride.

pharmachologic effect

Neuromidin belongs to the group of calcium channel blockers. Therefore, it helps reduce potassium levels in the body and, on the contrary, increases calcium in nerve endings. In addition, the drug prevents the effect of cholinesterase on neuromuscular fibers. Due to the occurrence of such processes, there is an increase in mediators in the body, namely adrenaline, serotonin, oxytocin and histamine.

The drug improves the transmission of nerve impulses in all areas of the muscles.

While taking this drug, there is a restoration of smooth muscle tone, synoptic connections and an improvement in mental activity, so new information is better and easier to remember.

The active component of the drug easily penetrates the bloodstream, and subsequently into the target organs.

Metabolism of drugs occurs in the liver. The highest concentration of the drug in the body occurs half an hour after use. The drug is excreted primarily through the excretory system.

Directions for use and doses

Inside, s/c or i/m. Doses and duration of treatment are determined individually, depending on the severity of the disease.

Pills

Diseases of the peripheral nervous system:

- mono- and polyneuropathy, polyradiculopathy, myasthenia gravis and myasthenic syndrome of various etiologies - 10-20 mg (0.5-1 tablet) 1-3 times a day. The course of treatment is from 1 to 2 months. If necessary, the course of treatment can be repeated several times with a break between courses of 1–2 months;

— to prevent myasthenic crises, in case of severe disorders of neuromuscular conduction, 1–2 ml (15–30 mg) Neuromidin® 1.5% solution for injection is administered parenterally for a short time, then treatment is continued with Neuromidin® tablets, the dose can be increased to 20–40 mg (1–2 tablets) 5 times a day.

Diseases of the central nervous system: bulbar paralysis and paresis, the recovery period of organic lesions of the central nervous system (traumatic, vascular and other origins), accompanied by motor and/or cognitive impairment - 10–20 mg (0.5–1 tablet) 2–3 times a day day. The course of treatment is from 2 to 6 months. If necessary, the course of treatment is repeated.

Treatment and prevention of intestinal atony - 20 mg (1 tablet) 2-3 times a day for 1-2 weeks.

Solution for intramuscular and subcutaneous administration

Diseases of the peripheral nervous system:

- mono- and polyneuropathy of various origins - subcutaneously or intramuscularly 5-15 mg 1-2 times a day, course - 10-15 days (in severe cases - up to 30 days); then treatment is continued with the tablet form of the drug;

- myasthenia gravis and myasthenic syndrome - subcutaneous or intramuscular 15-30 mg 1-3 times a day with further transition to the tablet form. The general course of treatment is 1–2 months. If necessary, treatment can be repeated several times with a break between courses of 1–2 months.

Diseases of the central nervous system:

— bulbar paralysis and paresis — subcutaneous or intramuscular 5–15 mg 1–2 times a day for 10–15 days; if possible, switch to tablet form;

- rehabilitation for organic lesions of the central nervous system - 10-15 mg intramuscularly 1-2 times a day, course - up to 15 days, then, if possible, switch to tablet form.

If the next dose was not taken on time, then it is not taken additionally.

The maximum daily dose is 200 mg.

Indications for use of the drug Neuromidin

Lesions of the peripheral nervous system - neuropathy, neuritis, polyneuritis, polyneuropathy, myelopolyradiculoneuritis, bulbar palsy and paresis; memory impairments of various origins (Alzheimer's disease and other forms of dementia in the elderly), mental retardation in children; lesions of the central nervous system of traumatic, vascular and other origins with impairments of memory, praxis, attention; myasthenia gravis and myasthenic syndromes; complex therapy of multiple sclerosis and other forms of demyelinating diseases of the nervous system; weakness of labor; intestinal atony.

Overdose

Symptoms: decreased appetite, bronchospasm, lacrimation, increased sweating, constriction of the pupils, nystagmus, increased gastrointestinal peristalsis, spontaneous bowel movements and urination, vomiting, jaundice, bradycardia, intracardiac conduction disturbances, arrhythmias, decreased blood pressure, restlessness, anxiety, agitation, feelings of fear, ataxia, convulsions, coma, speech impairment, drowsiness, general weakness.

Treatment: symptomatic therapy is used, m-anticholinergic blockers are prescribed (atropine, cyclodol, metacin, etc.).

special instructions

There are no systematic data on the use of Neuromidin® in children.

Alcohol should be avoided during treatment (it increases the side effects of the drug).

Impact on the ability to drive a car or perform work that requires increased speed of physical and mental reactions. During treatment, you should refrain from driving a car, as well as engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Release form

Tablets, 20 mg. 10 tablets each in blister packs made of PVC film and aluminum foil. 5 blister packs per cardboard pack.

Solution for intramuscular and subcutaneous administration, 5 mg/ml and 15 mg/ml. 1 ml of the drug in neutral glass ampoules (type I). 5 amp. in blister packs made of PVC film. 2 blister packs in a cardboard pack.

For the drug produced at SOPHARMA JSC, Bulgaria: 10 amp. in blister packs made of PVC film. 1 blister pack in a cardboard pack.